Tools For Black, Latino Women To Manage Health

I'm Michel Martin and this is TELL ME MORE from NPR News. Later, find out what reality show star Omarosa - excuse me, make that Reverend Omarosa is listening to these days.

But, first, we want to go behind closed doors. That's where we talk about sensitive issues that many people find hard to discuss. Health is one of those issues, but that's one reason we try to talk about some of the unique circumstances that affect the health, particularly of minority women, whether the issue is HIV/AIDS, diabetes or obesity.

Women of color suffer disproportionately from many of the major health problems in this country. So now, we have two guests who have written books that take on minority women's health, specifically.

Eleanor Hinton Hoytt is the president of the Black Women's Health Imperative and coauthor of the book, "Health First: The Black Woman's Wellness Guide."

Also with us once again, Jane Delgado. She is the president and CEO of the National Alliance for Hispanic Health. She's the author of "The Latina Guide to Health" and a trained psychotherapist.

Thank you both so much for speaking with us.

DR. JANE DELGADO: Thank you for having us.

ELEANOR HINTON HOYTT: It's great to be with you.

MARTIN: So I'm going to ask each of you in turn why you felt there was a need for this specific guide. A lot of people would say, well, you know, health is health. So Jane Delgado, why don't you start?

DELGADO: I guess, for us, the major thing is that there are so many stereotypes that are not true for Hispanics. For Hispanics, you know, women - one of the things I want to tell our women is, look, you may have excess weight, but remember, you have less heart disease than non-Hispanic white women and you live longer. Yes. We have diabetes, but there are things you can do to make your life better and it's not the same as you would for non-Hispanic white women.

MARTIN: Eleanor, you told us that one of your objectives specifically was not to address health disparities, per se, so what is the goal of the book and why not talk about health disparities?

HOYTT: The goal of the book is to give black women hope, hope that we can beat the odds. We are bombarded with what you are not doing right and so what we thought we would do would be to go to the women, go to some of the research and conduct research ourselves so that we could frame the questions in a way that would allow black women to see that they could have hope and that there are opportunities and, in particular, it's never too late and it's never too early to begin a journey toward health.

MARTIN: Eleanor, one of the things that also interested me is some of the things that African-Americans revere and that they appreciate about themselves, particularly about women of the community, are also some of the things that lead to poor health. For example, being prized and being regarded as the caretakers of the family is kind of the foundation of the family. You said that's a double-edged sword. Talk a little bit about that if you would.

HOYTT: That is such a double-edged sword. There are no rewards for being the strong black woman because we have, of all of the diseases and the isms, the depression, the lack of opportunities, the lack of employment, the lack of financial gains and working, the strong black woman puts us in a state of denial and does not allow us to come to grips with being overweight or having diabetes. And so we have to become as much of a self-giver as we are a caregiver.

MARTIN: Jane Delgado, do you find that, in your work, that there are aspects of the kind of Latino experience, particularly in the United States, that it's celebrated, but it's a double-edged sword when it comes to health?

DELGADO: Well, much of it applies to Hispanic women that also applies to African-American and all women, which is the ideas that we as women are caregivers. And while that's a good thing, in this society, we don't value that, so obviously, women - because we do this - we are not valued, as well.

But most important of all is this concept of putting yourself second. We say, OK. It's great that you want to take care of everyone, but you've got to be part of that equation, too.

MARTIN: You've made obesity a focal point of your work, Jane Delgado. The Centers for Disease Control and Prevention report that 43 percent of Latinos are overweight or obese compared to - and I know we don't want to spend a lot of time comparing - but just for way of comparison, 33 percent of white women.

And could you talk a little bit about that? Did you find cultural factors that you think are contributing to this or you think some of it's - is it diet? Is it - what?

DELGADO: With the Hispanic data that only came out in 2010 showing that Hispanic women live longer, they're having a hard time explaining all this because, you know, we've always been told, oh, you're fat, you're diabetic, you have this problem, that problem. But there are things to celebrate in every community and that's why I agree completely with what the Black Women's Health Project does. It's to celebrate who you are and how can you take what you are make it even better.

Even the term, obesity, you offend the very people you're trying to get a message out to.

MARTIN: What do you like better?

DELGADO: I like to talk about excess weight. And actually, at the Alliance what we focus on, what we know is a major problem in our community is lack of physical activity and lack of access to affordable fruits and vegetables. You know, low income mothers, they struggle to meet and make healthy diets. They don't wake up and say oh, I want to feed my family the worst food possible. They do what they can with the resources they have.

MARTIN: If you're just joining us, I'm Michel Martin and this is TELL ME MORE from NPR News. We're talking about minority women's health with two women who have recently written books on the subject.

Jane Delgado is the author of "The Latina Guide to Health." Eleanor Hinton Hoytt is the co-author of "Health First: The Black Woman's Wellness Guide."

And you've both talked a lot about trying to reframe these issues in ways that you feel make more sense for the communities that you're particularly interested. Eleanor, in your book you talk about when you moved to a new neighborhood with your teenage daughter and you noticed there was inadequate street lighting. And you said that that was a health concern for you and your daughter and a lot of people wouldn't see it that way. Tell me why you think that was a health concern and why you told that story.

HOYTT: I told that story because it's important for us to see health holistically. It is not only how you move and when you move and what you eat, whether it is where you live, where you work, the streetlights in your neighborhood, the sidewalks, having sidewalks or not and having streetlights. It is so important, it is a safety issue. The stress that that puts on us not feeling safe and secure as we walk to the grocery store that we may or may not have on a sidewalk that is not sidewalk-able or...

MARTIN: You think that affects the ability or willingness of people to exercise or to walk or to get adequate physical activity?

HOYTT: Absolutely. But it is more than that, that it is not just what we eat and where we walk and how we walk. We did a Harris poll of over 600 black women and most of those women said that they were healthy. We think we are healthier than we are.

MARTIN: How do you talk about that in a way that gets people to think about and prioritize their health but doesn't contribute to what you both kind of talk about as kind of this overwhelming drumbeat that suggests that, you know, minority women are always wrong and that there is something wrong with them that has to be fixed? And I'm just interested in how you talk about that. I'd like to hear that from both of you.

Jane Delgado, do you want to take that on?

DELGADO: Yeah.

MARTIN: Because, you know, with Latino women there's been some interesting conversations around the way, you know, Latino women are depicted as, you, has to be sexy and a spitfire and all this other business and how that, you know, what does that play into in terms of the way people feel they need to present themselves to the world.

So the question is how do you talk about it in a way that gets people to yes, this is something you need to do but doesn't contribute to this attitude of you know what, here's why you're wrong, here's why you're always going to be wrong, and here's why you need to be different?

DELGADO: We talk about nutrition and exercise as part of a 10 point program that includes healthy relationships, avoiding toxic air, taking your medicine, cherishing your spiritual life. All that is part of health. So it's not just one thing. And for Hispanic women, I always think when I look in television there are very few with any images of women who are not thin and sexy. They all have to be voluptuous, sexy and, you know, cha-cha-cha. But, in fact, that's not who we are.

(SOUNDBITE OF LAUGHTER)

DELGADO: And I would like, you know, when we see some more women who are a little more rounded, it'll be some progress. But it's going to be a long time because of the stereotype.

MARTIN: Eleanor, what about you?

HOYTT: I would like to shift the conversation. And we are beginning to have these conversations about wellness. And it's like the...

MARTIN: Wellness.

HOYTT: Wellness.

MARTIN: Wellness, not weight. OK.

HOYTT: Not weight. We must look at the total, the whole woman. How have I forgiven myself for having all of these curves? In my case, not having all of those curves when I was growing up. Have I forgiven my father or mother or sister or my best friend? We're asking black women to redefine what health means and not use white women as the gold standard.

MARTIN: Before we let each of you go I wanted to ask about an issue that's been in the news a lot lately - the whole question of reproductive health and reproductive rights. Women have a very broad range of attitudes around these issues just, you know, as men do. But there are those who are saying now that women's voices really aren't being heard in the political conversation right now. I wanted to know if you share that view, and if you think that is true what message do you think should be heard around questions of reproductive health?

DELGADO: I think that women's voices need to be heard because throughout health we don't hear women's voices. That's why it's only now we are documenting that heart disease is different for women. We have a long way to go.

MARTIN: Eleanor, what about you?

HOYTT: What we're finding is that black women's health does not matter where it should: at the policy table, in the board room, in the community, and in many cases in families. And we're trying to change that. We're trying to make black women's health matters. But what we do know is that most women spend over 30 years trying to control their reproductive health. Either trying to get pregnant, avoid pregnancy or to parent and or to have a healthy pregnancy. And that's why it's part of the eight essential health benefits services, part of the Affordable Care Act.

We think that it is time for women to stand up and speak out and to the assaults on women's health. It is not all right for white men to define not only who we are but how we relate to our bodies.

MARTIN: Before we let each of you go, moving forward, we've talked a lot about this already, but what do you think is the most important element in building a culture of wellness for women of color? What's the most important thing you'd like people to walk away from this conversation thinking about Jane, I'll go to you first.?

DELGADO: OK. I would say that there's no one thing because it's no one thing that's going to make you healthy. You know, there are people who exercise, exercise, but they don't do anything else. They smoke. So it's many things and that totality is what makes us human.

MARTIN: Eleanor?

HOYTT: I agree completely with Jane. There is no one thing. But what we try to put forth within our organization for almost 30 years is that self-love and self care are key components to a wellness journey. And so we are saying put your health first so that you can love yourself and take care of yourself and be around for others.

MARTIN: Eleanor Hinton Hoytt is the president and CEO of the Black Women's Health Imperative. She's co-author of the book "Health First: The Black Woman's Wellness Guide." Jane Delgado is president and CEO of the National Alliance for Hispanic Health. She's a trained psychotherapist and she's author of the book "The Latina Guide to Health." They were both kind enough to join us in our Washington, D.C. studios. And, you know what? They both look fabulous.